Social Work Case Manager

• Masters degree in Social Work Psychology Education PublicHealthor a related field with a minimum of three years of experience working with individuals with complex medicalbehavioraland psychosocial needs.

• Current state licensure as a social worker or related field

• Experience in patient education working with individual patients

• Knowledge of chronic health conditions preferred

• Must be self -starter willing to proactively seek out and learn about etiologycareand treatment for many healthconditions

• Excellent verbal and written communication skills in both English and Spanish preferred

• Computer literacy and ability to navigate through computer systems

• Skilled at deliver presentations

• Sound assessment and decision-making skills and highly ethical

• Excellent critical thinking and organizationalskillswithattentiontodetail

• Excellent time management skills and ability to manage multiple priorities

• Strong teamwork skills; ability to work collaboratively and consultatively with team members

• Ability to work independently and manage an assigned caseload

MemberSupportandEducation

• Outreachesto assess members social emotional environmental financial and support needs which areimpactinghealth outcomes

• Providesor arrangesfor resources necessary to meet members psychosocial needs

• Effectivelyutilizesmethods and models of social work intervention to engage members in care management

• Providesongoing health coaching and support self-management education condition-specific education care coordination and resources and materials

• Assistsmemberswhen necessary in placing calls completing applications and advocating for available supports/services

• Assistsmembers and providers with transition of care referral management care coordination and benefitmanagement

• Linksmembers toappropriate communityresources for health and health-related services consistent with regulatorycontractualand corporate requirements

• Researchesand sharescommunity resources with members and the case management team

• Promotesandencouragesmembercollaborationwiththeprimarycareproviderotherhealthcareprovidersandsocialserviceagencies

• Facilitatesinterdisciplinaryconsultationonmembersbehalfthroughparticipationinroundsteammeetingsandclinicalreviews

• Conductsface-to-facevisitswithselectedmembersasappropriate

• Completesdocumentationinthemedicalmanagementinformationsysteminatimelymannerandinkeepingwithinternalpolicyandaccreditation standards

• Conductsassessmentsviaphoneanddevelopaserviceplanwhichoutlinescleargoalstimeframesandresponsibilities

• Adherestodepartmentallyestablishedproductivitystandards

• MaintainsHIPAAstandardsandconfidentialityofprotectedhealthinformation

• Adherestodepartmental/organizationalpoliciesandprocedures

• Understandstheconceptsfeaturesbenefitsdisclosuresandprovisionsofgovernmenthealthinsuranceprograms

InternalCustomerSupportandEducation

• WorkscollaborativelyandcohesivelywithallmembersoftheCSITeaminordertocoordinateacontinuumofcareformembersconsistentwiththemembershealthcaregoalsandneeds

• FacilitatesmembercommunicationwithinternalpartnerssuchMemberServices

• Provides support for BH UM responsibilities as needed